January 12, 2021 update: A group of New York state lawmakers have just sent a letter requesting Governor Andrew Cuomo to include gig workers, such as food-delivery platform drivers for Uber Eats and Grubhub, as essential workers in line to receive the next round of COVID-19 vaccinations.

Although he has tested negative twice, the 77-year-old grocery store veteran knows he’s at risk. “It’s kind of scary,” said Evans. “We have thousands of people in and out of that store all the time, so there’s a lot of damage that can be done.”

He’s taking as many precautions as possible, but working in a grocery store puts Evans at risk, and his advanced age makes him more likely to develop life-threatening complications if he becomes infected. That’s why Evans wants food workers to be the next group, after healthcare professionals, to receive the COVID vaccine.

“We in the food industry deal with people and support them every day,” said Evans, who works in the meat department. “We keep the food system going.”

While the federal government has deemed food industry professionals such as grocery store workers, meatpackers, and farmworkers to be essential, it remains to be seen how soon they’ll be immunized.

An advisory group to the Centers for Disease Control and Prevention (CDC) recommended Sunday that essential workers and people 75 and older be vaccinated after healthcare professionals and residents of long-term care facilities. But roughly 49 million people—including food industry workers, first responders, prison guards, and teachers—make up this division of the labor force.

Moreover, states can decide which groups of workers within this broad category line up first during the second wave of vaccinations, or they can deviate from the recommendations of the Advisory Committee on Immunization Practices (ACIP) by prioritizing other groups of people, such as the incarcerated or homeless populations.

In California, Los Angeles County Supervisor Janice Hahn recently wrote a letter to Governor Gavin Newsom urging that teachers be placed in the first tier of workers vaccinated during the second phase, which the CDC describes as “Phase 1b.” Meanwhile, the California Latino Legislative Caucus is asking Newsom to prioritize farmworkers for inoculation, and a bill introduced in the state assembly in December aims to secure early immunization for farmworkers and grocery workers. Democratic congressman Josh Harder, who represents part of the agriculture-intensive Central Valley, is also pushing for agricultural workers to be vaccinated early because of the essential role they play in society.

Grocery and Other Food Industry Advocates Mounting Pressure

Research on farmworkers in California, the nation’s largest agricultural state, indicates that they are three times more likely to contract the novel coronavirus than workers in other sectors. And according to the United Food and Commercial Workers International Union (UFCW), which represents 1.3 million food and retail workers, at least 350 of its members have died of COVID-19 complications and 48,000 have been infected or exposed to the virus. This includes 19,800 meatpacking workers and 17,400 grocery workers. In Los Angeles, a COVID epicenter, supermarkets have been linked to record outbreaks. For all these reasons, these workers’ advocates and medical professionals assert that they should get the vaccine without delay.

“Protecting our country’s food workers is essential to keeping our communities safe,” said UFCW International President Marc Perrone in a statement. “CDC Director [Robert] Redfield must recognize the vital role these essential workers serve by ensuring that they are among the first to receive access to the COVID-19 vaccine.”

Norma Leiva, a warehouse manager at a Food 4 Less in Panorama City, California, said a chance to receive the vaccine would go a long way toward making her feel less vulnerable. The 51-year-old is particularly afraid of contracting the virus and transmitting it to her grandchild, her elderly mother-in-law, or her husband, who suffers from hypertension. Leiva herself struggles with chronic bronchitis.

“If I could have something that would help me not get sick and bring it home, that would totally make me more at ease at my job,” said Leiva.

Farmworkers are Vulnerable but Wary

Conducted between July and November by researchers at the University of California, Berkeley’s School of Public Health, the study found that 13 percent of farmworkers have tested positive for coronavirus, compared to 5 percent of the state’s general population. The report also determined that 20 percent of farmworkers have COVID-19 antibodies compared to only 1 percent of the San Francisco Bay Area population as a whole. The impact of coronavirus on their lives has been devastating, farmworkers told researchers who completed the study in partnership with the Clinica de Salud del Valle de Salinas. It has resulted in the deaths of loved ones and in rising rates of food insecurity in the region dubbed the nation’s “salad bowl.”

Given these circumstances, Dr. Maximiliano Cuevas, CEO of Clinica de Salud del Valle de Salinas, contends that farmworkers should be vaccinated immediately. “We’re trying to argue that food production is critical to the safety of the nation, so we need to protect those people who produce food for the rest of us,” he said. “Right now, it’s an uphill climb. Farmworkers are not a priority, and they should be up there with health workers and first responders.”

Inadequate screening, crowded housing, and shared commutes in packed vehicles have led to soaring infection rates among farmworkers. But even major agricultural states like California have not announced plans to vaccinate farmworkers in this first wave. And, yet, Cuevas asserts that their health impacts other industries—from restaurants to supermarkets. “It’s a domino effect,” he said.

Should the vaccine become quickly available to farmworkers, there’s no guarantee that they would all agree to take it, however. The U.C. Berkeley report found that while 52 percent of farmworkers indicated they were extremely likely to get vaccinated, 20 percent weren’t sure if they would, and 11 percent said they were unlikely or very unlikely to do so. Fear of side effects, distrust of the government, and fear that the vaccine itself could cause a COVID-19 infection were the main reasons farmworkers cited for declining the vaccine.

“We know that it’s safe and effective, but people in general don’t trust it,” Cuevas said. “So, I think we have to educate people, let them know what the process is like and that we can say with a pretty high degree of certainty that this thing is effective.”

Farmworkers are one of several groups in the food chain likely to show signs of “vaccine hesitancy,” said Brenda Eskenazi, a U.C. Berkeley School of Public Health graduate school professor. A coauthor of the farmworker study, she added that it’s important that public health outreach is conducted in multiple languages, as farmworkers in the Salinas Valley speak at least 12 different Indigenous dialects, including Mixtec, Zapotec, and Triqui. Language barriers have contributed to confusion among farmworkers about how to get tested for coronavirus, and the same could happen when it’s time to take the vaccine. For one group of farmworkers, just getting the two required doses of the vaccine 28 days apart could be tricky, said Eskenazi.

“We need to consider that we have a mobile population of farmworkers, so how do we ensure that before they move to Yuma, Arizona, they’re getting vaccinated in Salinas, California?” she asked. “We have to consider the mobility issue.”

There’s also the stark reality that as many as half of the country’s 2.4 million farmworkers are undocumented, and a large and growing number are in the U.S. as guest workers. Cuevas said that it would be a mistake to require anyone to provide immigration documentation to receive the vaccine. “Anyone who’s a human being needs to be able to get it,” he said.

But convincing people who are hiding in the shadows to come out and get vaccinated will require effort, Eskenazi said. Community clinics like Clinica de Salud del Valle de Salinas can play a vital role in this endeavor. Because they already serve this population, “they’re going to be more trusted by the people who may be undocumented,” she said.

Meatpacking Workers Have (Some) Industry Support

The North American Meat Institute (NAMI), made up of representatives from the beef, pork, lamb, and poultry industries, sent letters to both a CDC advisory group and the nation’s governors at the start of December asking them to immunize meatpacking and food processing workers early. Now that a panel of health experts has advised the CDC to inoculate food industry workers and the very elderly in the second wave of vaccinations, NAMI is both applauding the recommendation and indicating that it may offer assistance.

“Priority access to vaccines is a critical step for the long-term safety of the selfless frontline meat and poultry workers who have kept America’s refrigerators full and our farm economy working,” said NAMI CEO Julie Anna Potts in a statement. “Meat and poultry leaders may also be able to aid vaccination for all Americans, for example by offering state-of-the-art cold storage for these precious vaccines” the statement added.

In states like Nebraska, which has more than 26,600 meatpacking workers, making it the top state for that industry, advocates say a vaccine can’t come soon enough. The American Civil Liberties Union filed a federal lawsuit in November alleging that the Noah’s Ark Plant in Hastings, Nebraska has failed to protect its majority Black and Latinx workers and the public. [Update: In early January, Nebraska Governor Pete Ricketts announced that undocumented workers in the state’s meat packing plants would not be eligible for the vaccine and then reversed his position two days later.]

A plaintiff in that lawsuit, known only as “Alma” to protect her from retaliation, said in a statement that workers are terrified of contracting COVID-19, but management downplayed their concerns about the virus, describing their fears as “nonsense.”

“Even when things got more serious, they didn’t care,” Alma said. “We were all worried, because everyone has kids. But if you stopped working, you would lose your job.”

Nebraska State Senator Tony Vargas introduced legislation over the summer to get Governor Pete Ricketts to take steps to protect meatpackers, but to no avail. Now Vargas would like to see these workers become the first in the state, after healthcare professionals and residents of long-term care facilities, to receive the vaccine.

“Our meatpacking plant workers are in conditions where they can’t socially distance, where there have been outbreaks for months,” Vargas said. “The very least that we can do is ensure that these workers have a vaccine so that we’re not putting them in harm’s way.”

The cause is important to Vargas, in part, because he lost his father to coronavirus in April. After going public with that news, he began to field calls from meatpacking workers affected by COVID-19. Those already infected with the virus complained that they faced pressure to return to work as soon as possible.

“People are incentivized to come back to work very quickly, and incentivizing people to come back to work in a pandemic is not what we should be doing,” Vargas said. “We were hearing continued stories of retaliation from people who didn’t come back to work, and we continue to hear stories of individuals being left in the dark on whether or not other individuals around them test positive.”

Vargas concedes that some plants are testing workers more frequently and providing them with more personal protective equipment, but he said that coronavirus outbreaks continue to be traced back to meatpacking facilities. “There’s consistent room for growth,” he said.

This includes public health outreach about the vaccine. It must be culturally inclusive, with trusted leaders, news outlets, and others disseminating accurate information about the immunization process, said Vargas. The senator has heard concerns from Nebraskans of color worried about the risks associated with the vaccine. To allay public fears, he is participating in public information campaigns. But he also went a step farther—he took part in a vaccine trial earlier this year.

“I wanted people to see that, as a person who identifies as Latino, I’ve participated in the trial and I’m okay,” he said. “Everything’s been fine. People are equally afraid of the vaccine as they are of the virus, so we must do more to build that trust and dispel any myths.” Access to healthcare is another important factor, he adds.

Magaly Licolli also wants to see more companies and lawmakers lobby for meat processing workers to get vaccinated. Licolli is executive director of Venceremos, an advocacy group for poultry plant workers in Arkansas, a top state for poultry processing.

Workers are desperate to take it, Licolli said. Those who haven’t been infected live in fear of contracting it, and they see co-workers who survived the virus living with long-term health problems. “I have a worker who has 65 percent lung capacity, and he’s not been able to return to work after five months,” she explained.

Most poultry workers in her state aren’t skeptical about immunization, she asserted, but eager for it to make a major difference in their lives. “There is huge hope,” she said.